English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

Background and Aims The long waiting list for deceased donor kidney transplantation has prompted the use of Expanded Criteria Donors (ECD) though it is possibly associated with worse graft function and outcomes than Standard Criteria Donors (SCD). Our centre had also implemented a protocol kidney biopsy at implantation from 2005 to 2009. The aim of this study was to evaluate the impact of donor factors and donor kidney histology on 10-year graft outcomes. Method A retrospective analysis was performed on 108 kidney transplant recipients who underwent a protocol biopsy at implantation from November 2005 to November 2009. The biopsy sample was evaluated for glomerulosclerosis, tubular atrophy, interstitial fibrosis and arteriolar narrowing and scored according to Remuzzi et al., N Engl J Med. 2006;354(4):343 (Remuzzi score). Donor factors evaluated were donor age, hypertension, diabetes mellitus, and terminal serum creatinine. The 10-year graft survival and estimated glomerular filtration rate (eGFR) was the main outcome of interest. Results The deceased donors included 58% males, 85% Chinese, with a median age of 49 (IQR 12) years. There were 13% diabetics, 51% hypertensive donors and the median terminal creatinine was 95 umol/L. The recipients were 51% male, 79% Chinese, with a median age of 47 (IQR 11) years at transplant. The time interval to transplant was 9.2 (IQR 3.0) years and the overall 10-year graft survival was 67.6%. Remuzzi score of ≤3 was associated with better 10-year graft survival compared with Remuzzi score of &amp;gt;3 (76.6% versus 45.2%, P =0.02). 10-year graft survival for SCD and ECD was not statistically different (71.6% versus 58.8%, P=0.187). A multivariate analysis was performed which included donor status (ECD vs SCD), Remuzzi score (&amp;gt;3 vs ≤3), donor age (≥60 or &amp;lt;60 years), donor hypertension, donor diabetes mellitus and terminal serum creatinine (≥133 umol/L versus &amp;lt;133 umol/L). Only Remuzzi score correlated with a better 10-year graft survival rate (P=0.020). All other factors did not correlate with 10-year graft survival. Amongst the 73 ten-year graft survivors, the median eGFR at year 10 was 47.5 (IQR 20.3) ml/min if the Remuzzi Score was ≤3 while the eGFR was 39.7 (IQR 33.0) ml/min if Remuzzi score was &amp;gt;3. However, this difference was not statistically significant (P=0.570). The 10-year eGFR was 45.8 (IQR 22.2) for SCD kidney recipients vs 49.5 (IQR 25.6) for ECD kidney recipients. Paradoxically, the median eGFR was higher with the ECD cohort but this was not statistically significant (P=0.443). Conclusion An implantation Remuzzi score of more than 3 is associated with poorer long-term graft survival as compared to other donor factors evaluated on 10-year graft survival or eGFR. Where possible, assessment of the kidney histology should be included as part of the kidney selection and allocation process in order to determine long term outcomes.

P1727DECEASED DONOR KIDNEY CHARACTERISTICS AND IMPACT ON 10-YEAR GRAFT SURVIVAL - A LONG-TERM OBSERVATIONAL STUDY